Frozen donor eggs: initial findings

It’s hard to know where to start this post about frozen donor eggs. All of the research I’ve been gathering over the past few weeks has been bubbling in the background, like some crazy stew in a cauldron in the corner, and I have been reluctant to tiptoe over there and taste it. I feel overwhelmed. But I have to start somewhere. So here it goes.

I have been looking most closely at a frozen donor egg program at a clinic in Atlanta, Georgia, called Reproductive Biology Associates (RBA). RBA founded My Egg Bank, which is basically a bank of frozen donor eggs. Yes: strange. But also: good. Good for people who don’t have a lot of money to gamble with. When undergoing a DE cycle using frozen donor eggs, there is more certainty, in terms of what you are getting. And RBA’s guarantee program (which I’ll describe in greater detail in a later post) would perhaps allow us other options, financially, for starting a family, should DE not work.

Yes, we have more or less decided that if we pursue DE, we will participate in some sort of guarantee program. No matter what we do next, we need to ensure that we don’t blow all of our resources on one shot. After all, if a success rate is 80%, someone has to be in that unlucky 20%.

PROS of frozen donor eggs:

  • You don’t have to worry anxiously about how many mature eggs the donor will produce–you know exactly how many mature eggs you are buying from the bank.
  • You know there aren’t going to be any unreliability problems with the donor–she has already undergone all screenings and has already undergone IVF.
  • You don’t have to synch your cycle with the donor’s cycle.
  • You don’t have to wait to be matched—matching happens as soon as you choose a donor’s lot of frozen eggs.
  • There is a 30K guarantee program offered by RBA in Atlanta–if no live birth is achieved after 5 regular cycles (+ up to 5 frozen embryo transfers), you get 15K back to pursue another path to creating a family.
  • Frozen embryos from frozen eggs—they thaw as successfully as embryos created from fresh eggs.
  • A 2012 article in Fertility and Sterility reports that there is no increase in chromosomal abnormalities in embryos from frozen eggs.
  • Frozen Donor Eggs Gaining Popularity for Conception : This article is great for breaking down the historical timeline of IF and ART, including frozen donor eggs. The infographic is helpful (if you can forgive the image of the lone infertile woman surrounded by 9 happy, stretching, sauntering pregnant women).
  • ASRM: Egg Freezing No Longer “Experimental”This article in Ob.Gyn.News reports that the ASRM investigators found that “92.5% of vitrified oocytes survived warming, and that there were no significant differences in fertilization rates (74% vitrified vs. 73% fresh), implantation rates (40% vs. 41%), and pregnancy rates per transfer (55.4% vs. 55.6%) between groups.” It also describes how the ASRM is not encouraging women to use frozen donor eggs to delay childbearing. (Basically because a woman would have to freeze her eggs at a really young age for it be a real fertility insurance policy—but who knows, maybe it will become commonplace for a woman to undergo a few IVFs and oocyte vitrifications before she turns 25, in the not-too-distant future. Maybe freezing one’s eggs will become as commonplace as getting an annual PAP.)
  • Are frozen eggs as good as fresh in creating IVF pregnancies? According to this abstract, yes.
  • Better freezing techniques and avoiding hyperstimulationAnother great abstract, with this info: “The agonist trigger donor’s mean anti-mullerian hormone (AMH) was 4.6, mean antral follicle count (AFC )32, mean peak estradiol (E2) 5330. With a mean of 21 mature eggs, 81% fertilized and 10 excellent blastocysts were achieved per donor. Pregnancy rate was 93%….If high AMH donors were chosen for egg banking, the number of eggs would be enough for 3 recipients receiving 7 eggs each and each would be expected to have 3 excellent blasts.”
  • Cost, technology drive frozen egg donation growthDr. Shapiro at RBA in Georgia says: “”People sit down and they do a simple little [math],” he said. “They quickly come to the conclusion that a couple of cycles with us gives a higher cumulative likelihood of pregnancy than one fresh cycle any place else, and it still comes out less.”
  • Deep FreezeThis article in Atlanta Magazine is quite dated (it is almost 4 years old) but it has a great description of what actually happens in the RBA lab when they rapid-freeze—vitrify—eggs.
  • Positive Forum Discussions re: frozen DE and RBA: 
  1. RBA Frozen Egg Bank – How many tries does it take? Guarantee vs standard program?
  2. http://forums.fertilitycommunity.com/donor-issues-egg-sperm/2020186396-success-frozen-donor-eggs-2.html
  3. http://forums.fertilitycommunity.com/donor-issues-egg-sperm/2020190690-reproductive-biology-associates.htm

CONS of frozen donor eggs:

  • According to this press release, the “experimental” label on egg freezing was lifted extremely recently by the American Society for Reproductive Medicine (ASRM)—the label was lifted in October of 2012 (!). But this quote from the press release sounds pretty damn good: “Oocyte cryopreservation is an exciting and improving technology, and should no longer be considered experimental. Pregnancy rates and health outcomes of the resulting children are now comparable to those of IVF with fresh eggs” –Eric Widra, MD, Chair of the Society for Assisted Reproductive Technology (SART) Practice Committee.
  • RBA has been offering its program to the public for only three years (but they have been practicing the technique for perhaps a decade).
  • The ongoing pregnancy rate quoted by My Egg Bank is 60%–that is 20% lower than the 80% success rate at Advanced Fertility Center of Chicago for a fresh DE cycle. (But Chicago’s fresh DE guarantee program is far, far more expensive than RBA’s frozen DE guarantee program, and it offers one less cycle, and less certainty in terms of eggs produced, donor reliability, synching, etc.)
  • Because this technique is relatively new, SART has not tracked stats (but doesn’t SART simply report what clinics report to them, in any case?). And I have not been able to find many personal stories out there from women about their experiences using frozen DE.
  • If I did have a successful pregnancy, there is less chance of my having frozen embryos to transfer later–less chance, that is, of genetically linked siblings.
  • Although the first baby born from frozen donor egg in 2007 is doing fine, and there have not been reports of increased risk of birth defects with frozen DE, and the ASRM says the health outcomes of the resulting children are the same as that of the kids born of fresh eggs, I do worry about the dearth of data available. When compared to IVF, which has been around since 1978, and fresh donor egg IVF, which has been around since 1983, frozen donor egg cycling is really just beginning.
  • Frozen donor egg banks – should we use frozen or fresh donor eggs to do egg donation? This blog post, written by Chicago’s Dr. Sherbahn, warns against using frozen donor eggs. BUT it was written almost 2 years ago—and in the ART world, as I’m beginning to realize, that is a great deal of time. Would he still warn against frozen DE today, I wonder?

A mix of PROS/CONS, frozen donor eggs:

  • Time to Chill? Egg-freezing Technology Offers Women a Chance to Extend Their Fertility.  In this article—written 2 years ago—Dr. Schoolcraft warns that a woman in her mid-30s, attempting to preserve her own fertility, would have to freeze 20 of her eggs to be reasonably sure of 1 pregnancy. (But I would be using the eggs of a donor who is under 30 years old.)
  • Egg Freezing Changing Fertility TreatmentsAn interesting CNN article. (And the comments section is heated. You hear fertile people judging and pushing adoption on women who would consider using DE. Some of the incredibly ignorant comments remind me of the judgment I could face in the future.) What concerns me is this: This woman received a lot of 12 eggs from My Egg Bank/Atlanta in November of 2012, and she ended up with only one possibility for a successful pregnancy: “A dozen frozen eggs were shipped from Atlanta to New York for Vernon. Eight survived the thaw, she says, and five were successfully fertilized and grown from embryos to blastocysts. Only four of the blastocysts were viable on the day they were to be transferred into Vernon’s uterus. Two were transferred. /She wanted to freeze the other two blastocysts, but they didn’t survive long enough to be frozen. She had no more left./ After 13 years of trying to have a baby, this really did feel like her last chance./One of the blastocysts didn’t take, but the other one did. Debbie Vernon is now eight and a half weeks pregnant, full of both hope and fear for the baby she’s carrying.”

Ah! It felt good to organize all of that. I will post more about RBA in particular in the days to come. Long story short: What I have found so far is allowing me to feel the first reluctant, hesitant tendrils of new hope.

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3 Comments

  1. Sigal

     /  February 14, 2017

    Hi there,

    Thank you for all the information.
    Im too looking to start my journey at
    RBA and was looking for more information online.
    I see that this was 4 years ago. I wonder what was the outcome and your experience with RBA?

    Regards
    Sigal

    Reply
  1. Reproductive Biology Associates (RBA) and their guarantee | the unexpected trip
  2. Frozen donor eggs and CCRM | the unexpected trip

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